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COURSE IN THE WARDS

COURSE IN THE WARDS. UPON ADMISSION. URINALYSIS. Platelet concentrate transfusion 2U Prednisone 10mg/5ml, 7ml TID after meals Lactulose 10 ml ODHS Patient developed abdominal pain. - Omeprazole 10mg/SIVP QD . 2 nd HOSPITAL DAY.

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COURSE IN THE WARDS

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  1. COURSE IN THE WARDS

  2. UPON ADMISSION

  3. URINALYSIS

  4. Platelet concentrate transfusion 2U • Prednisone 10mg/5ml, 7ml TID after meals • Lactulose 10 ml ODHS • Patient developed abdominal pain. - Omeprazole 10mg/SIVP QD

  5. 2nd HOSPITAL DAY • Patient had 3 episodes of vomiting of previously ingested food. • Cefuroxime500mg/IV q8 was given.

  6. 3RD HOSPITAL DAY • Patient was given Salbutamol 2mg/5ml syrup, 4 ml q8 due to persistence of cough.

  7. 4THHOSPITAL DAY • Patient was transfused with 2 units of type specific platelet concentrate. • Gum bleeding (+) for blood clots -Tranexamic acid 250mg/tab diluted in 250ml cold water, gargled TID. • Left ear pain (+)impacted cerumen on both ears. -Baby oil was instilled on both ears, 2-3 drops for 3 x a day.

  8. 5TH HOSPITAL DAY • Persistence of fever (T 39.5-40.5) - Cefuroxime was shifted to Ceftazidime 500mg/IV infusion over 30 minutes q8. - Amikacin 80mg/SIVP q8 was also given. • Blood culture and sensitivity was requested • Transfuse with 240ml of properly typed and crossmatched packed RBCs

  9. 6TH HOSPITAL DAY • Patient had increased appetite and was less irritable. • Still complained of left ear pain experienced productive cough.

  10. 7TH HOSPITAL DAY • Transfused 2 units of type specific platelet concentrate.

  11. Referred to ENT Assessment : Impacted cerumen, AU t/c post auricular cellulitis. Otosol drops 3gtts q8 hours AU

  12. 9TH HOSPITAL DAY • Referred to Ophthalmology Assessment: Subconjunctival Hemorrhage, OS Periorbital Hematoma, OU • Advised to apply cold compress 15 mins TID x 48 hrs on both eyes then warm compress thereafter

  13. Fluconazole was started Dosage: 200mg/capsule, 1 capsule as loading dose Then ½ capsule OD as maintenance dose to begin 24 hrs after. LOADING DOSE= 12mg/kg BW = 12mg x 16 kg = 192g MAINTENANCE DOSE = 6mg/kg BW = 6mgx 16 kg = 96g

  14. 10TH HOSPITAL DAY • Transfused with 2 units of type specific platelet concentrate.

  15. 11TH HOSPITAL DAY BLOOD CULTURE AND SENSITIVITY BACTEC 9120 (AEROBIC) SPECIMEN: BLOOD WITH ARD FINAL REPORT: No growth after 5 days incubation

  16. 12TH HOSPITAL DAY • Aural irrigation done, AU Findings: (+) Perforated TM, hyperemic TM, AS Impression : COM, AS, Active Suggest to start Chloramphenicolotic drops 2 gtts TID x 7 days • Referred to Pedia-Nutrition

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